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FOCUS ON YOUR CLASSICAL TEXTS – Part II

Literature of Ayurveda – Brihatrayi – Sushruta Samhita and Astanga Hridaya

 

Sushruta Samhita

Sushruta belongs to Dhanvantari school of thought and is believed to be the Father of Surgery in Ayurveda. Kashiraj Divodas, who is believed to be the second incarnation of Lord Dhanvantari, laid the foundation of Sushruta Samhita. Later in 2nd Century BC, Sushruta reshaped it in a proper text form.  Nagarjuna in  5th  century and  candraöa in  10th  century  revised  the  compilation,  which  is  the existing form of Sushruta Samhita available nowadays.

Sushruta         2nd Century BC

Nagarjuna      5th Century AD

candraöa         10th Century AD

Contents-

Original Sushruta Samhita comprises of 120 chapters. First few sections are similar to Charaka Samhita, but the last section is called as uttaratantra (Appendix). In addition to the main subject of surgery, uttaratantra includes description about the topics on ENT disorders, paediatrics and medicine. The  original  text  is  in  prose  form while  the  last  section  is  in  poetic form which suggests that uttaratantra is an addendum to the original text. The meaning of the word uttaratantra (last section) also reveals the same.

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Sutra Sthana

 Sutra sthana includes 46 chapters which deal with surgery.

  • First chapter explains the evolution of surgical training, aims and objectives of Ayurveda and the importance of surgical branch
  • Second chapter consists of an index and references to the most important subjects
  • The other  chapters  cover  basic  principles  of  surgery,  important  surgical instruments,  different  methods  of  cauterization,  application  of  leeches, wounds  and various subjects of internal medicine- like seasonal regimen, pathyapathya (Diet regimen), Nine kriyakala i.e.  Pathogenesis, disease classification, prognosis, various therapies and some principles like rasa, virya and vipaka are also discussed.

 Nidana Sthana

It includes 16 chapters which explain the aetiology of mainly surgical diseases like haemorrhoids, urinary calculus, fistula-in-ano, diabetes, ascites, abscess, breast abscess, fractures and hernia.

Sharir Sthana

Sushruta Samhita is said to be the best in Sharir sthana, which consists of 10 chapters. This includes human anatomy, embryology and marma-vijnyana (knowledge of vital points which is the essential for surgeons)

Chikitsa Sthana

This  section  includes  40  chapters which  comprise  the  treatment  of  the  diseases mentioned  in nidana sthana. This section also includes important topics like rasayana, vajikaran and panchakarma.

Kalpa sthana

This section has 8 chapters. They elaborate various recipes for the evacuation procedures compiled under panchakarma and also deal with toxicology.

Uttaratantra

It  contains  66  chapters  which  cover  topics  like  ENT,  paediatrics,  internal medicine, preventive medicine and psychiatry.

Salient features of Sushruta Samhita

  • Procedure of human body dissection by maceration method was first ever described in Ayurveda by Sushruta. The sage author also emphasized that the physician or surgeon should not be authorized to treat any patient unless he has gained knowledge of human body by performing dissection under the guidance of his guru
  • Knowledge of anatomy which includes count and description of bones, joints, nerves is praiseworthy. Anatomy and physiology of heart, blood and circulation, layers of skin are also described in depth
  • Its classification of fractures, wounds, abscesses and burns, as well as the elaboration of procedures, have all stood the test of time. These include simple surgical procedures like dressing, bandaging as well as more complex procedures like cataract operation, anorectal surgery and plastic surgery
  • Sushruta is believed to be the first plastic surgeon, since he performed operation for cleft lip, cleft palate and rhinoplasty. The same methods are being used till date. Thus Sushruta can be considered as father of surgery
  • A unique concept of pathogenesis is described by Sage Sushruta This concept is about tracking the pathogenesis of disease as six successive stages of gradual manifestation or progression of disease. These stages if identified by the physician are six vital opportunities for him to start early measures for prevention and treatment of the disease and also to timely arrest its worsening
  • Beautiful description of arrangement of the hospital and  the  ideal behavior of  the patient guides  us  regarding  the  establishment  of  various  wards  in  the modern hospitals of today’s era
  • A portrayal of an ideal operation theater can also be found in Sushruta Samhita
  • Description of about 100 varieties of  blunt  instruments  and  20  types of sharp instruments is found in Sushruta Samhita. Various types of sutures are also mentioned. Concept of sterilization was also known during that period and instruments were sterilized by boiling in water. Fumigation is also mentioned in order to avoid post operative wound infections.
  • Excellent sixty different methods for wound and ulcer treatment are mentioned.
  • Management of emergency cases like burns, drowning, hanging and strangulation has been explained. Sushruta has extensively dealt with abdominal sections, setting of fracture and dislocations, removal of haemorrhoids and amputation of limbs.
  • Classification of plants according to their action. Single drug therapy like Haridra ie. Turmeric (Curcuma longa) for diabetes, tuvaraka (Ceaesalpinia paniculata) for skin disease was introduced.

Commentaries on Sushruta samhita

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Vagbhata Samhita (Astanga SangrahaAstanga Hridaya)

This is comparatively recent treatise from the Brihatrayi.

Vagbhata (seventh century AD) was the author of the text hence the name. This treatise is believed to be a summary of Charak and Sushruta with selected additions from other Ayurvedic writers like Agnivesha, Bhela and Harita to make the text up to date. He introduced a number of new herbs and made valuable modification and additions.

Contents – It has six sections containing 120 chapters.

Vagbhata had written the text with the verses in a beautiful poetry form which enables the student to memorize important subject in a concise form in an easier manner.

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Salient features of Astanga Hridaya

  • Concise and poetic presentation
  • Beautiful well-edited compilation of the best concepts from Charak and Sushruta
  • Pharmacology is very well elaborated. Concept of vipaka e. post digestive effect of edible substances is very well defined
  • Many plants are mentioned for their specific action on a particular disease for e.g. guduchi (Tinospora cordifolia) for vatarakta (gout); musta (Cyperus rotundus) for jvara (fever).
  • Newer formulations were introduced in many diseases for e.g. Surana Putapaka for haemorrhoids;, Mandur Vataka for anaemia, etc.
  • Instant oleation formulae and 4 new types of fomentation are contributions to panchakarma
  • Different surgical instruments like catheters, trochars and canulas are described as näòéyantra

Commentaries on Astanga hridaya

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